Hickory Flat Clinic, LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

R855906 Issued in MS

Legal business name

HICKORY FLAT CLINIC, LLC

Practice address

250 Oak St
Hickory Flat, MS 38633

Phone

(662) 551-6492

NPI assigned

Mar 20, 2013

Last updated

Mar 20, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephanie Thompson, FNPNPI 1811150402

Title

FNP

Phone

(662) 551-6492

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8477/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Elaine Thompson, FNP

  • Family Nurse Practitioner
  • Hickory Flat, MS
  • NPI 1811150402
  Medicare reassignment Authorized official
• Velma Sue Morrisson, CFNP

  • Family Nurse Practitioner
  • New Albany, MS
  • NPI 1043213853
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1326380189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6492 BECK SPRINGS RD",
            "city": "HICKORY FLAT",
            "state": "MS",
            "postal_code": "386339116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 OAK ST",
            "city": "HICKORY FLAT",
            "state": "MS",
            "postal_code": "38633",
            "telephone_number": "662-551-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY FLAT CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "662-551-6492",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MS",
            "license": "R855906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09426886",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hickory Flat Clinic Association Inc
• Lauren Kirkman, FNP-C
• Mary Allison Ormon Rakestraw, ST
• Stephanie Elaine Thompson, FNP
• Tammy L Thompson, LPN

• Community Health Clinic/Center in Hickory Flat, MS
• Providers in Hickory Flat, MS by specialty
• Community Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.